Route this form to:
Accounts Receivable Services
1300 S. 2nd St. Suite 295
Minneapolis, MN 55454
Phone: 612-625-2392
Fax: 612-626-3969
Email: acctrec@umn.edu
Accounts Receivable Reporting Form
U Wide Form:
UM 1591
Rev: 5/18/15
This form should be completed for each department that maintained a departmental billing/accounts receivable system or
completed any billing activity outside of the EFS Billing Module that meets any of the following criteria:
 Had an accounts receivable balance on June 30, 2014
 Had any accounts receivable activity during FY2015
 Had an accounts receivable balance on June 30, 2015
 Sent an invoice or bill to a non-University customer during FY2015
Please complete a separate form for each departmental billing/accounts receivable system and return by July 10, 2015 to
the address referenced above.
Resource Responsibility Center (RRC)
Department Name(s)
Dept ID(s)
Summary Information
1. Did your department use a subsidiary system or other non-EFS method to invoice in FY2015? Yes:
2. Did you convert your billing activity to EFS during FY2015?
Approximate date converted?
Yes:
No:
No:
____________________________
3. Describe your department’s activity (e.g. goods, services) being invoiced:
Prepared by:
Printed Name:
Phone:
Title:
Fax:
E-mail:
Signature:
Approved by:
Printed Name:
Phone:
Title:
E-mail:
Signature:
Accounts Receivable Services Use Only
Date Received:
 Prev FY Bal  Rollforward  Calc  Chartstring  Write-offs
Entered:
Follow-up:
The University of Minnesota is an equal opportunity educator & employer.
 2015 by the Regents of the University of Minnesota.
Page 1 of 7
Route this form to:
Accounts Receivable Services
1300 S. 2nd St. Suite 295
Minneapolis, MN 55454
Phone: 612-625-2392
Fax: 612-626-3969
Email: acctrec@umn.edu
Accounts Receivable Reporting Form
Attachment A - Recording Information
U Wide Form:
UM 1591
Rev: 5/18/15
Billing and Accounts Receivable System
1. What system(s) does your department use to issue invoices and track receivables? (check all that apply)
Word processing program (e.g. Word)
Paper files
Spreadsheet (e.g. Excel)
Database (e.g. Access)
Purchased Software:
Full Name of software package:
Version Number:
Department Developed Software: Full Name of system:
How much does your department spend annually to maintain this system(s)? $
Do you have any maintenance agreements in place?
Yes:
No:
If YES, when does the maintenance agreement(s) expire?
How often do you upgrade your software?
Annually
Every 2 Years
Every 3-5 Years
Other
When was the last time you upgraded?
Do you have any plans to upgrade the system, or purchase or develop a replacement system?
Yes:
No:
If YES, please describe your plans:
The University of Minnesota is an equal opportunity educator & employer.
 2015 by the Regents of the University of Minnesota.
Page 2 of 7
Route this form to:
Accounts Receivable Services
1300 S. 2nd St. Suite 295
Minneapolis, MN 55454
Phone: 612-625-2392
Fax: 612-626-3969
Email: acctrec@umn.edu
Accounts Receivable Reporting Form
Attachment A - Recording Information (continued)
U Wide Form:
UM 1591
Rev: 5/18/15
Billing Activity
2. How many external invoices did your department bill in FY2015?
3. From these invoices, how many different customers did your department bill?
4. Is your customer base:
Very static – typically bill the same customers month-to-month
Somewhat dynamic – some customers are billed every month, but several new ones are added
Very dynamic – typically bill a new set of customers each month
5. How often does your department prepare billings?
Daily
Weekly
Monthly
Other
6. Describe your invoice numbering system and list current invoice number:
(example: invoice numbers are 6 digits long, sequentially assigned by the system, current number is 377524)
7. Attach a sample copy of your invoice(s).
Payment Processing and Application
8. What method(s) of payment do you accept for your invoiced activity?
Currency/Coin
Check
Credit/Debit Card
ACH/Wire
Other
9. How often does the department prepare deposits for monies received?
The day the payment is received
Within 1 week of payment receipt
Other
Collection Activity
10. How often does your department monitor aging reports and perform collection activity on past due invoices?
Daily
Weekly
Monthly
Quarterly
Other
11. Do you have written collection procedures?
Yes:
If YES, attach a copy of your collection procedures.
If NO, describe your collection process:
No:
12. Does your department use the services of an outside debt collector?
If YES, what is the name of the collection agency(ies) you use?
Yes:
No:
13. Attach a sample copy of your statement of account and/or dunning correspondence.
The University of Minnesota is an equal opportunity educator & employer.
 2015 by the Regents of the University of Minnesota.
Page 3 of 7
Route this form to:
Accounts Receivable Services
1300 S. 2nd St. Suite 295
Minneapolis, MN 55454
Phone: 612-625-2392
Fax: 612-626-3969
Email: acctrec@umn.edu
Accounts Receivable Reporting Form
Attachment B – Rollforward, Write-Offs, Reconciliation to GL
June 30, 2014 Gross Receivables Balance
$
FY2015 Billings/Revenues (Note 1)
+
FY2015 Receipts
-
FY2015 Write-offs (Note 2)
-
Other FY2015 adjustments (Note 3)
+/-
U Wide Form:
UM 1591
Rev: 5/18/15
(A)
Select either + or -
June 30, 2015 Gross Receivables Balance (Note 4) = $
(B)
Dollar Amount Change from June 30, 2014
(If change > $50,000 complete Note 5 on page 6)
(B – A)
$
Percentage of Change
(If change > 25% complete Note 5 on page 6)
%
(B – A)/A
Note 1: Report here the chartstrings used to record your sales. If more than one, list separately including dollar amount for
each chartstring. Please attach a separate sheet if you need more room to complete this section. The total of all amounts
should equal the total reported in the above rollforward schedule for FY2015 Billings/Revenues.
Fund
DeptID
Program
Account
FinEmplID
CF1
CF2
Amount
Total Amount:
Note 2: If you had write-offs during FY2015, please complete this section.
Amount of FY2015 write-offs approved by Accounts Receivable Services:
Amount of FY2015 write-offs approved in your department (each under $25):
Total (agrees to the rollforward schedule above):
Chartstring where write-offs recorded (for departments that process Journal Entries for recording receivables):
Fund
DeptID
Program
Account
Do you have written write-off procedures?
Yes:
If YES, attach a copy of your write-off procedures.
If NO, describe your write-off process:
FinEmplID
CF1
CF2
No:
The University of Minnesota is an equal opportunity educator & employer.
 2015 by the Regents of the University of Minnesota.
Page 4 of 7
Route this form to:
Accounts Receivable Services
1300 S. 2nd St. Suite 295
Minneapolis, MN 55454
Phone: 612-625-2392
Fax: 612-626-3969
Email: acctrec@umn.edu
Accounts Receivable Reporting Form
Attachment B – Rollforward and Write-Offs (continued)
U Wide Form:
UM 1591
Rev: 5/18/15
Note 3: If you had adjustments during FY2015, please provide an explanation:
Note 4: Do you process your own Journal Entries for recording receivables?
Yes:
No:
If NO,
a. Provide departmental chartstring to record the revenues
Fund
DeptID
Program
Account
FinEmplID
CF1
CF2
b. Select an account to record the receivables:
110016
Other 110
If YES,
a. List the Journal IDs of the journals used to record the receivables and the offsetting entry.
b. How often does the department record receivables activity to the General Ledger?
Daily
Weekly
Monthly
Yearly
Other
c.
Who in the department is responsible for reconciling Accounts Receivable detail to EFS?
Name:
Phone:
d. Do you have written reconciliation procedures? Yes:
If YES, attach a copy of your reconciliation procedures.
If NO, describe your reconciliation process:
e. How often is reconciliation performed?
Daily
Weekly
Monthly
f.
No:
Yearly
Other
Have you reconciled billings/revenues and/or related accounts receivable sub-ledger to EFS at June 30,
2015?
Yes:
No:
g. Attach your June 30, 2015 reconciliation.
The University of Minnesota is an equal opportunity educator & employer.
 2015 by the Regents of the University of Minnesota.
Page 5 of 7
Route this form to:
Accounts Receivable Services
1300 S. 2nd St. Suite 295
Minneapolis, MN 55454
Phone: 612-625-2392
Fax: 612-626-3969
Email: acctrec@umn.edu
Accounts Receivable Reporting Form
Attachment B – Rollforward and Write-Offs (continued)
U Wide Form:
UM 1591
Rev: 5/18/15
Note 5: Has the June 30, 2015 aggregate dollar amount of your receivables changed by more than $50,000 or 25% from
June 30, 2014? Yes:
No:
If YES, please provide an explanation:
Is the year end-receivables balance typical of the receivables balance you maintained throughout the fiscal year?
Yes:
No:
If NO, please explain:
Have you invoiced all product shipped & services rendered as of June 30, 2015? Yes:
If NO, please explain:
Do you bill in advance for any goods or services?
If YES, please describe:
Yes:
No:
No:
Have you recorded all invoices in your accounts receivable sub-ledger? Yes:
No:
The University of Minnesota is an equal opportunity educator & employer.
 2015 by the Regents of the University of Minnesota.
Page 6 of 7
Route this form to:
Accounts Receivable Services
1300 S. 2nd St. Suite 295
Minneapolis, MN 55454
Phone: 612-625-2392
Fax: 612-626-3969
Email: acctrec@umn.edu
Accounts Receivable Reporting Form
Attachment C - Detailed Accounts Receivable Listing
and Allowance for Uncollectible Accounts
U Wide Form:
UM 1591
Rev: 5/18/15
An allowance should be set on the basis of the department’s knowledge about the collectability of specific accounts, with
a general provision based on historical experience, as needed.
An aging report by customer is REQUIRED. Attach spreadsheet or aging report from departmental system if more
convenient.
Customer
Name
Total Balance
6/30/2015
90 Days Old
and Under
91 Days to
1 Year Old
Over 1 Year
Old
Estimated Amount
Uncollectible
(enter amt or 0)
Totals:
Note 6 –Attach an explanation of how allowance is calculated by your department.
June 30, 2014 Allowance for Uncollectible Accounts
$
(A)
June 30, 2015 Allowance for Uncollectible Accounts
$
(B)
Dollar Amount Change from June 30, 2014
$
(B – A)
Percentage of Change
%
(B – A)/A
Has the June 30, 2015 allowance for uncollectible accounts changed by more than $50,000 or 25% from June 30, 2014?
Yes:
No:
If YES, please provide an explanation:
The University of Minnesota is an equal opportunity educator & employer.
 2015 by the Regents of the University of Minnesota.
Page 7 of 7